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What is a palatal expander?

September 30th, 2020

Orthodontists like Dr. Richard E. Dunn recommend a first orthodontic visit and evaluation for your child around the age of seven. We will evaluate your child’s jaw and facial development and make sure that there is enough room in the mouth for the permanent teeth when they arrive. One of the recommendations we might make for early treatment is the use of a palatal expander. If you are unfamiliar with this device, let’s take a closer look at why it’s necessary and what exactly it does.

Why do we recommend the palatal expander?

There are two dental arches, composed of the upper and the lower teeth, in your child’s mouth. This arch-shaped design is meant to accommodate all the permanent teeth. Further, when the upper and lower teeth meet, they should result in a healthy occlusion, or bite.

Sometimes, the upper dental arch is simply too small to accommodate all of your child’s permanent teeth, leading to crowding, extractions, and impacted teeth. Also, a too-narrow arch can result in a crossbite, where some of the upper teeth bite inside the lower ones. An improper bite can lead to problems such as TMJ (temporomandibular joint) disorder, improper wear and stress on teeth, certain speech difficulties, and other potential complications. The palatal expander was designed to prevent these problems from occurring.

What is a palatal expander and how does it work?

The expander itself is a device that increases the size of the upper dental arch. Before your child’s bones are finished growing, the space between the two bones of the upper palate is filled with cartilage. This tissue is flexible when children are young, but gradually fuses solidly into place by the time they are finished growing (usually in the early to mid-teens). If the arch can be widened to accommodate the emerging permanent teeth, or to reduce malocclusions, this improvement can also affect the need for, and length of, future dental work.

There are several types of expanders available at our Visalia, CA office. These are custom-made appliances, commonly attached between the upper teeth on each side of the jaw. The two halves of the device are connected with a screw-type mechanism that can be adjusted to widen the upper palate and dental arch with gentle pressure. This is a gradual process, with small adjustments usually made once or twice a day to slowly move the bones further apart. As weeks go by, you will notice a successful change in the spacing of the teeth. Your child might even develop a gap in the front teeth, which is normal and will generally close on its own.

If you would like more detailed information, talk to Dr. Richard E. Dunn about the palate expander. We can tell you what to expect from this treatment if we think it is best for your child’s unique needs, and how to make it as easy as possible for your child. Our goal is to provide your child with the healthiest teeth and bite possible, always making use of treatments that are both gentle and effective.

How Long Do I Need To Wear Retainers?

September 23rd, 2020

Once you get your braces off, you want to make sure your smile remains straight! This is where retainers come in.

Once your braces come off, you’ll be fitted for a retainer provided by Dr. Richard E. Dunn to keep those teeth in place. A retainer is a custom-fit device that sits in the mouth and reinforces the new position of your teeth. Wearing it may be annoying at first, but it’s an essential part of the process of keeping your teeth in place over the long term.

For the first few months after your braces are gone, Dr. Richard E. Dunn will tell you to wear your custom retainers all the time, except when you’re eating, drinking, or brushing. You have the option of having a clear plastic retainer made if you’re concerned about your appearance.

Eventually, we will recommend that you only have to wear the retainer during each night for a full year. After that, you may take a couple nights off from wearing them each week. In order to preserve the position of your teeth for as long as possible, we don’t recommend that you ever fully stop wearing your retainers.

If you’re concerned about forgetting to wear your retainer, and worried that your teeth may shift, a lingual retainer could be a good option for you. This gets placed on the back of your teeth and is not readily visible.

These retainers are permanent, but they could cause issues for you down the road if you don’t maintain good oral hygiene. Plaque and tartar can build up around these lingual bars, which is why we don’t usually recommend this as a primary choice.

Wearing your retainer is extremely vital after your braces come off. Without your retainer to keep them in place, the teeth you’ve taken so long to fix may begin to shift again. Getting braces is quite an investment, which is why you should keep wearing your retainer long after the braces have come off.

If you have questions or concerns regarding your retainers, contact our Visalia, CA office and we can address any problems you may have.

Just What Is Plaque?

September 16th, 2020

From the time you were small, you’ve been warned about the dangers of plaque. Why? Because:

  • It’s an unpleasant film that sticks to your teeth
  • It causes cavities
  • It causes gum disease
  • It can cause extra problems when you wear braces

And really, do we need to know much more than this to motivate us to brush? But if you’re in a curious mood, you might be wondering just how this soft, fuzzy film accomplishes all that damage. Let’s take a closer look at the sticky problem of plaque.

How does plaque form?

We live with hundreds of species of oral bacteria, most of which are harmless, and some of which are actually beneficial. But when our oral ecosystem gets out of balance, problems can occur. For example, without regular and thorough brushing and flossing, we start to build up plaque.

Plaque starts forming within hours of your last brushing. And even though plaque fits the very definition of “seems to appear overnight,” this biofilm is actually a complex microbial community with several different stages of development.

  • It starts with saliva.

Saliva is vital to our oral health, because it keeps us hydrated, washes away food particles, neutralizes acids in the mouth, and provides minerals which keep our enamel strong. Saliva also contains proteins, which help form a healthy, protective film on the tooth surface. This film is called a pellicle.

  • Bacteria attach to the pellicle.

There are species of oral bacteria that are able to attach themselves to the pellicle film within hours of its formation. As they become more firmly attached, they begin to grow and divide to form colonies, and are known as the early colonizers of the plaque biofilm.

  • A complex biofilm forms.

If you’ve skipped brushing for a few days (please don’t!), you’ll notice a fuzzy, sometimes discolored film on your enamel—that’s a thriving plaque community, and it only takes a matter of days to go from invisible to unpleasant.

If you’re not removing plaque regularly, it can harden further and become tartar. And once you have tartar buildup, you’ll need the care of a dental professional to remove it.

  • What happens if we ignore plaque and tartar?

We get cavities and gum disease.

How does plaque cause cavities?

  • The bacteria in plaque, like all organisms, need nutrients.

Our normal oral environment and the food in our everyday diets provide the nutrients plaque needs. And, as we mentioned above, certain types of oral bacteria convert these nutrients into acids. Foods such as carbohydrates, starches, and sugars are most easily converted into acids, which is why we recommend that you enjoy them in moderation.

  • The biofilm promotes acid production.

Within the plaque film, anaerobic bacteria (bacteria which don’t use oxygen) convert sugars and starches into acids. As the plaque film becomes denser, it blocks acid-neutralizing saliva and oxygen from reaching these bacteria close to the tooth’s surface, creating an ideal environment for the bacteria to produce their acid waste products.

  • Acids attack enamel.

The sticky nature of plaque keeps these acids in contact with tooth enamel, where, over time, acids dissolve minerals in enamel, weakening the mineral structure of the tooth.

How does plaque cause gum disease?

  • Bacteria cause inflammation and gingivitis.

The bacteria in plaque irritate the delicate tissue of the gums, which causes an inflammation response which can leave your gums swollen, red, bleeding, or tender. This early form of gum disease is gingivitis. Fortunately, good dental care and careful brushing and flossing can usually prevent and even eliminate gingivitis.

  • Plaque and tartar can lead to periodontitis.

When plaque and tartar build up around and below the gumline, the gums pull away from the teeth, leaving pockets where bacteria collect, leading to infection as well as inflammation. Infections and constant inflammation not only harm gum tissue, they can destroy the bone supporting the teeth. This serious gum condition is periodontitis, and should be treated immediately to avoid further infection and even tooth loss.

How does plaque affect orthodontic patients?

  • Plaque collects around your braces.

Braces provide plenty of spots for plaque to hide from your brush. If you aren’t extremely diligent with your brushing and flossing, plaque collects near brackets, wires, and bands—all those spots that a brush and floss find difficult to reach.

  • Plaque promotes demineralization

The demineralization process we mentioned above can cause white spots on teeth (decalcification), where minerals have dissolved. Sometimes these spots can be treated, and sometimes they are permanent. They can become quite sensitive, and may lead to cavities.

Careful brushing and flossing around your braces will help eliminate the plaque that can cause demineralization near brackets. Ask Dr. Richard E. Dunn about the tools and the brushing and flossing techniques which will give you the best results.

How do we fight plaque?

From the time you were small, you’ve learned how to fight plaque:

  • Brush at least twice a day for two minutes, and be sure to brush all of your tooth surfaces and around the gumline.
  • Floss to remove plaque from between the teeth and near the gumline.
  • See your dentist as recommended for a thorough professional cleaning.

Be proactive. If you have any questions, talk to us at our Visalia, CA office about the best way to keep plaque at bay. We can show you the most effective ways to brush and floss, recommend anti-plaque toothpastes and rinses, even suggest plaque-revealing tablets if you’re missing some trouble spots.

We’ve only brushed up on some plaque basics, because there is a lot more to discover about this complex biofilm. Happily, even with all there is to learn about plaque’s growth and development, it’s reassuring to know that getting rid of it is quite simple—with just a soft-bristled brush, some dental floss, and a few minutes of your time each day, you’re on the way to a healthy, happy, plaque-free smile.

Find Out how Your Diet can Cause Cavities

September 9th, 2020

Sometimes food that’s good for your body isn’t necessarily the best for your teeth. Dr. Richard E. Dunn and our team want you to know which healthy foods can harm your teeth and gums, and what steps you can take to continue enjoying these foods, even when you’re dieting.

When you begin to substitute empty calories with whole foods, make sure you also remember to focus on your dental health. The majority of people tend to switch out sugary foods in favor of fruits and vegetables when they diet.

It’s worth knowing that most fruits are highly acidic and composed of natural sugars. Some of the highly acidic fruits to watch out for include apples, grapes, strawberries, pineapples, blueberries, oranges, and grapefruit. Moderation is key here, as with all other things. Fruits can be a great source of energy to help you through your day, but try not to overdo them.

Often, people also incorporate more leafy greens into their diets, which mean plenty of salads. Salad dressing is another item you’ll want to watch out for. Many dressings are filled with vinegars and sweeteners that include harmful acids, which change the pH of your mouth. When your mouth shifts from alkaline to acidic, your smile also turns to a higher risk for erosion and decay.

Rather than get rid of these foods altogether, simply change what you do after you eat them. Rinse your mouth out with water, brush your teeth, or eat alkalizing foods after consuming these acidic foods. Healthy alkalizing foods include dairy products such as eggs and yogurt, or any type of vegetable.

If you have questions regarding your current diet and its effect on your oral health, please contact our Visalia, CA office and speak with a member of our staff. If you’ve begun to make changes in your diet toward a healthier lifestyle, we hope these tips can help your make positive changes to your oral health. Our team at Richard E. Dunn, DDS, MS wants a healthy lifestyle to be a top priority in your life.

Richard E. Dunn, DDS, MS (559) 625-3030
101 W. Tulare Ave
Visalia, CA 93277